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Increasing early protein intake is associated with a reduction in insulin-treated hyperglycemia in very preterm

Ajit Mahaveer1, Christopher Grime, Colin Morgan

  • 1Neonatal Intensive Care Unit, Liverpool Women's Hospital, Liverpool, UK.

Nutrition in Clinical Practice : Official Publication of the American Society for Parenteral and Enteral Nutrition
|April 21, 2012
PubMed

Insights

Optimizing parenteral nutrition (PN) in very preterm infants by starting a new standardized concentrated neonatal parenteral nutrition (scNPN) regimen earlier improved protein intake. This enhanced protein delivery reduced the incidence of hyperglycemia requiring insulin treatment in these vulnerable infants.

Area of Science:

  • Neonatalogy
  • Pediatric Nutrition
  • Intensive Care Medicine

Background:

  • Impaired early protein intake in very preterm infants is linked to growth failure and neurodevelopmental issues.
  • Standardized concentrated neonatal parenteral nutrition (scNPN) can enhance early protein delivery.
  • A modified scNPN regimen initiated within 4 hours aims to further improve very early protein intake.

Purpose of the Study:

  • To assess if a new scNPN regimen improves very early protein intake in infants <29 weeks' gestation.
  • To determine if this improved intake occurs without significant PN intolerance or complications.
  • To compare outcomes with a previous scNPN regimen.

Main Methods:

  • A cohort of 38 infants (<29 weeks' gestation) receiving the modified scNPN regimen (group scNPN2) was studied.
  • This group was compared to 38 infants receiving the original scNPN regimen (group scNPN1).
  • Data on nutrition intake, metabolic status, and infections were collected.

Main Results:

  • Group scNPN2 received earlier PN, resulting in significantly higher protein intake (15.3 g/kg) in the first 7 days compared to group scNPN1 (11.8 g/kg).
  • Calorie, lipid, and carbohydrate intake remained similar between groups.
  • The incidence of insulin-treated hyperglycemia decreased from 53% in group scNPN1 to 26% in group scNPN2.

Conclusions:

  • Earlier initiation of the modified scNPN regimen effectively increases protein intake in very preterm infants.
  • Increased early protein intake is associated with a reduced need for insulin to manage hyperglycemia.
  • The modified scNPN regimen appears safe and beneficial for very preterm infants.
Abstract

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